EXPLORING COMMUNITY PERCEPTION AND ACCEPTABILITY TOWARDS COMMUNITY-BASED MODERN CUTANEOUS LEISHMANIASIS TREATMENT IN DEGA OCHOLO, GAMO ZONE, SOUTH ETHIOPIA: A PRAGMATIC QUALITATIVE STUDY APPROACH

Abstract

Introduction: Leishmaniasis is a vector-borne disease caused by protozoan parasite of the genus Leishmania. Globally, about 350 million peoples are at risk. In Ethiopia, Cutaneous Leishmaniosis (CL) continues to be a significant public health concern due to its high incidence. All three forms of CL occur in Ethiopia, and almost all cases are caused by the parasite Leishmania aethiopica, In rural areas in both northern and southern Ethiopia, more than ninety percent of CL affected patients use traditional treatment while, nobody knew about or sought modern treatment. Community based modern CL treatment is proposed to be given in Dega Ocholo Villege in southern Ethiopia, but nothing is known regarding community perception and acceptability towards modern CL treatments in the area. Thus, this study was aimed to explore the community’s perception and acceptability towards community-based modern CL treatments and identified possible acceptability barriers and facilitators before intervention. Objective: The aim of this study was to explore community’s perception and acceptability towards community-based modern CL treatment in Dega Ocholo, Gamo Zone, South Ethiopia, 2022. Method: In this study a total of 52 in-depth interviews were conducted, 26 before treatment and 26 after treatment from purposively selected active CL patients, community leaders, traditional healers, health extension workers, and previous CL patients with healed CL (scars). Ethically approved and pretested in depth interview guide was used. Each interview was recorded using an audio tape recorder and the recorded interview was transcribed, translated, and thematically analyzed independently by two experts using ATLAS Ti7 software. The findings were presented in narratives based on each major theme. Result: This study showed that there was a clear interest in and willingness to accept the modern CL treatments in pre-treatment findings, and also in the post-treatment findings the society were highly satisfied with the treatment and increased interest of using modern CL treatment. Even though traditional treatments were perceived by most of the participants to be ineffective and harmful, they were not satisfied with or preferred them, and they used them for a long time by perceiving them as the only option to treat CL. This study showed that limited access of information, fear of different costs, unavailability and accessibility of drugs, physical or geographical inaccessibility and expected efficacy of community based modern CL treatments were the most consequential sub-themes that were emerged as that prevented the community from receiving modern CL treatment at facility level. Conclusion and recommendations; this study showed that the acceptability of the community-based modern CL treatment interventions was outstanding. The community based treatment avoided all the potential barriers for the community due to its easy availability, accessibility, convenient follow-up schedule, simplicity of use. Therefore, minimizing barriers and strengthening facilitators with efforts from government, partners and stakeholders should be made to scale-up a community-based modern CL treatment in country wide approach.